Kitagawa Yoshimasa, Ohga Noritaka, Asaka Takuya, Sato Jun, Hata Hironobu, Helman Joseph, Tsuboi Kanako, Amizuka Norio, Kuge Yuji, Shiga Tohru
Oral Diagnosis and Medicine, Division of Oral Pathobiological Science, Graduate School of Dental Medicine, Hokkaido University, Japan.
Dental and Oral Surgery, Hokkaido Cancer Center, Sapporo, Japan.
Jpn Dent Sci Rev. 2019 Nov;55(1):65-70. doi: 10.1016/j.jdsr.2018.12.001. Epub 2019 Mar 15.
Medication-related osteonecrosis of jaws (MRONJ) is one of the most complicated inflammatory conditions in oral and maxillofacial region. It is very difficult to correctly evaluate the degree and extent of necrosis and infection. This refractory osteonecrosis often needs extended surgery, leading to impaired quality-of-life. We have performed hyperbaric oxygen therapy (HBO) combined with conservative surgery for advanced cases. We have appraised the value of FDG-PET and 3-phase bone scintigraphy in the diagnosis and management of this condition. MRONJ showed significantly higher SUV on FDG-PET than the others. Although the 3 phase pool bone images did not change significantly, perfusion and static bone image as well as PET showed remarkable response to HBO for MRONJ. SUV after HBO was significantly lower than those of before HBO. These preliminary results indicate that FDG-PET is useful for monitoring the effect of HBO for MRONJ.
药物相关性颌骨坏死（MRONJ）是口腔颌面部最复杂的炎症性疾病之一。正确评估坏死和感染的程度及范围非常困难。这种难治性骨坏死常常需要进行扩大手术，导致生活质量受损。我们对晚期病例采用了高压氧治疗（HBO）联合保守手术。我们评估了FDG-PET和三相骨闪烁显像在这种疾病诊断和治疗中的价值。MRONJ在FDG-PET上的SUV显著高于其他情况。虽然三相骨池图像没有明显变化，但灌注和静态骨图像以及PET显示HBO对MRONJ有显著反应。HBO治疗后的SUV显著低于治疗前。这些初步结果表明，FDG-PET有助于监测HBO对MRONJ的治疗效果。
